The Affordable Care Act (ACA) has made great strides since it was signed into law in 2010 to ensure that basic preventative services like well-woman visits and contraception recommended by their doctor, are now covered and require no co-pays, nor out of pocket expenses. This is so important because as we all know, the sooner a potential illness is discovered, the quicker is can hopefully be treated successfully.
In order to avoid any possible confusion, the U.S. Departments of Health and Human Services, Labor and Treasury issued a guidance that spells out exactly what’s covered. Insurers must cover at least one form of contraception including:
Oral contraception (the pill)
The Departments also clarified a few other important preventative services like:
- If a woman is at increased risk for having a potentially harm mutation in genes that suppress tumors – the BRCA-1 or BRCA-2 cancer susceptibility gene – a plan or issuer must cover the preventive screening, genetic counseling, and BRCA genetic testing with no cost-sharing, as long as the woman had not been diagnosed with BRCA-related cancer. Women with the BRCA-1 and 2 mutation have a risk of breast cancer that is about five times the normal risk, and a risk of ovarian cancer that is about 10 to 30 times normal.
- Makes clear for transgender people that issuers cannot limit preventive services based on an individual’s sex assigned at birth, gender identity or recorded gender. Issuers should cover the preventive services that an individual’s provider, not an insurance company, determines are medically appropriate.
- Clarifies that if a plan or issuer covers dependent children, they must provide recommended preventive services for those dependent children. This includes recommended services related to pregnancy, including preconception and prenatal care.
- Indicates that issuers cannot impose cost-sharing for anesthesia services performed in connection with preventive colonoscopies.
This is great news for all women, but it only works as well as we all know about our rights. Let’s be our own health advocates and be sure to share this news within our networks and families.